{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:37:22Z","timestamp":1788827842473,"version":"build-2803163510"},"reference-count":28,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Nonsyndromic unicoronal synostosis is associated with variability of severity in orbital morphology and ophthalmological manifestations. The relation between the two is not fully understood, nor how surgical treatment with fronto-orbital advancement and remodelling (FOAR) changes the relation. The aim of this study was to elucidate associations between ophthalmological manifestations and variations in orbital morphology and globe:orbit volume ratios preoperatively and at long-term follow-up after surgery. Twelve children referred to Uppsala Craniofacial Center who underwent computed tomography and standardized ophthalmological examinations regarding strabismus, spherical equivalent, astigmatism, anisometropia, and subnormal vision preoperatively and at 3 years of age were included. Orbits and globes were segmented. Principal component analysis elucidated morphological variation, and symmetry between orbital pairs was measured as the Dice similarity coefficient and globe:orbit volume ratios were calculated. The defined orbital shape variations were correlated with strabismus, refractive error, and subnormal vision. Different shape variations were associated with strabismus pre- and postoperatively and ipsi- and contralateral astigmatism. Greater improvement in orbital symmetry after surgery was associated with improvement in astigmatic anisometropia and new onset strabismus at follow-up. A small globe:orbit volume ratio was associated with preoperative strabismus, while the opposite was seen at follow-up. Different mechanisms seem to cause strabismus pre- and postoperatively, and FOAR might not sufficiently correct orbital morphology.<\/jats:p>","DOI":"10.2340\/jphs.v59.42322","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T08:27:19Z","timestamp":1733992039000},"page":"162-170","source":"Crossref","is-referenced-by-count":3,"title":["Variations in orbital morphology, globe:orbit volume relation, and ophthalmological outcome in unicoronal synostosis"],"prefix":"10.2340","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5562-0942","authenticated-orcid":false,"given":"Hanna M.","family":"Lif","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6444-2034","authenticated-orcid":false,"given":"Evangelia","family":"Ntoula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9674-0094","authenticated-orcid":false,"given":"Eva","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-9314","authenticated-orcid":false,"given":"Daniel J.","family":"Nowinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"90190","doi-asserted-by":"crossref","unstructured":"Touz\u00e9 R, Paternoster G, Arnaud E, et al. Ophthalmological findings in children with unicoronal craniosynostosis. Eur J Ophthalmol. 2022;32(6):3274\u20133280. https:\/\/doi.org\/10.1177\/11206721221077548","DOI":"10.1177\/11206721221077548"},{"key":"90191","doi-asserted-by":"crossref","unstructured":"Ntoula E, Nowinski D, Holmstrom G, et al. Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery. BMJ Open Ophthalmol. 2021;6(1):e000677. https:\/\/doi.org\/10.1136\/bmjophth-2020-000677","DOI":"10.1136\/bmjophth-2020-000677"},{"key":"90192","doi-asserted-by":"crossref","unstructured":"Di Rocco C, Paternoster G, Caldarelli M, et al. Anterior plagiocephaly: epidemiology, clinical findings, diagnosis, and classification: a review. Childs Nerv Syst. 2012;28(9):1413\u20131422. https:\/\/doi.org\/10.1007\/s00381-012-1845-2","DOI":"10.1007\/s00381-012-1845-2"},{"key":"90193","doi-asserted-by":"crossref","unstructured":"Luo W-T, Chen X, Zhang Y-D, et al. Ophthalmological outcomes of unilateral coronal synostosis in young children. BMC Ophthalmol. 2020;20(1):318. https:\/\/doi.org\/10.1186\/s12886-020-01547-1","DOI":"10.1186\/s12886-020-01547-1"},{"key":"90194","doi-asserted-by":"crossref","unstructured":"Levy RL, Rogers GF, Mulliken JB, et al. Astigmatism in unilateral coronal synostosis: incidence and laterality. J AAPOS. 2007;11(4):367\u2013372. https:\/\/doi.org\/10.1016\/j.jaapos.2007.02.017","DOI":"10.1016\/j.jaapos.2007.02.017"},{"key":"90195","doi-asserted-by":"crossref","unstructured":"Samra F, Paliga JT, Tahiri Y, et al. The prevalence of strabismus in unilateral coronal synostosis. Childs Nerv Syst. 2015;31(4):589\u2013596. https:\/\/doi.org\/10.1007\/s00381-014-2580-7","DOI":"10.1007\/s00381-014-2580-7"},{"key":"90196","doi-asserted-by":"crossref","unstructured":"Gencarelli JR, Murphy A, Samargandi OA, et al. Ophthalmologic outcomes following fronto-orbital advancement for unicoronal craniosynostosis. J Craniofac Surg. 2016;27(7):1629\u20131635. https:\/\/doi.org\/10.1097\/SCS.0000000000003085","DOI":"10.1097\/SCS.0000000000003085"},{"key":"90197","doi-asserted-by":"crossref","unstructured":"Ntoula E, Nowinski D, Holmstr\u00f6m G, et al. Strabismus and refraction in non-syndromic craniosynostosis \u2013 a longitudinal study up to 5 years of age. Acta Ophthalmol. 2024;102(5):564\u2013572. https:\/\/doi.org\/10.1111\/aos.16605","DOI":"10.1111\/aos.16605"},{"key":"90198","doi-asserted-by":"crossref","unstructured":"Yu JW, Xu W, Wink JD, et al. Strabismus in unicoronal craniosynostosis: effect of orbital dysmorphology and fronto-orbital advancement and remodeling. Plast Reconstr Surg.2020;145(2):382e\u2013390e.https:\/\/doi.org\/10.1097\/PRS.0000000000006479","DOI":"10.1097\/PRS.0000000000006479"},{"key":"90199","doi-asserted-by":"crossref","unstructured":"Villavisanis DF, Blum JD, Cho DY, et al. Long-term aesthetic and photogrammetric outcomes in non-syndromic unicoronal synostosis: comparison of fronto-orbital distraction osteogenesis and fronto-orbital advancement and remodeling. Childs Nerv Syst. 2023;39(5):1283\u20131296. https:\/\/doi.org\/10.1007\/s00381-023-05857-9","DOI":"10.1007\/s00381-023-05857-9"},{"key":"90200","doi-asserted-by":"crossref","unstructured":"Alford J, Derderian CA, Smartt JM, Jr. Surgical treatment of nonsyndromic unicoronal craniosynostosis. J Craniofac Surg. 2018;29(5):1199\u20131207. https:\/\/doi.org\/10.1097\/SCS.00000000\u200b00004509","DOI":"10.1097\/SCS.0000000000004509"},{"key":"90201","doi-asserted-by":"crossref","unstructured":"Elhusseiny AM, MacKinnon S, Zurakowski D, et al. Long-term ophthalmic outcomes in 120 children with unilateral coronal synostosis: a 20-year retrospective analysis. J AAPOS. 2021;25(2):76.e1\u201376.e5. https:\/\/doi.org\/10.1016\/j.jaapos.2020.\u200b10.013","DOI":"10.1016\/j.jaapos.2020.10.013"},{"key":"90202","doi-asserted-by":"crossref","unstructured":"Lif, H. M., Nysj\u00f6, J. E., Vegelius, J. R., Unander-Scharin, J., Enblad, P., & Nowinski, D. J. (2023). Persistent discrepancies in orbital morphology after surgical treatment of unicoronal craniosynostosis: a critical image-based analysis. Journal of neurosurgery. Pediatrics, 1\u201310. Advance online publication. https:\/\/doi.org\/10.3171\/2023.1.PEDS22349","DOI":"10.3171\/2023.1.PEDS22349"},{"key":"90203","doi-asserted-by":"crossref","unstructured":"Levasseur J, Nysj\u00f6 J, Sandy R, et al. Orbital volume and shape in Treacher Collins syndrome. J Craniomaxillofac Surg. 2018;46(2):305\u2013311. https:\/\/doi.org\/10.1016\/j.jcms.2017.11.028","DOI":"10.1016\/j.jcms.2017.11.028"},{"key":"90204","doi-asserted-by":"crossref","unstructured":"Khonsari RH, Hennocq Q, Nysj\u00f6 J, et al. Defining critical ages for orbital shape changes after frontofacial advancement in crouzon syndrome. Plast Reconstr Surg. 2019;144(5):841e\u2013852e. https:\/\/doi.org\/10.1097\/PRS.0000000000006162","DOI":"10.1097\/PRS.0000000000006162"},{"key":"90205","doi-asserted-by":"crossref","unstructured":"Bellaire CP, Devarajan A, Napoli JG, et al. Craniofacial dysmorphology in infants with non-syndromic unilateral coronal craniosynostosis. J Craniofac Surg. 2022;33(6):1903\u20131908. https:\/\/doi.org\/10.1097\/SCS.0000000000008464","DOI":"10.1097\/SCS.0000000000008464"},{"key":"90206","doi-asserted-by":"crossref","unstructured":"Ramdat Misier KRR, Breakey RWF, van de Lande LS, et al. Correlation between head shape and volumetric changes following spring-assisted posterior vault expansion. J Craniomaxillofac Surg. 2022;50(4):343\u2013352. https:\/\/doi.org\/10.1016\/j.jcms.2021.05.004","DOI":"10.1016\/j.jcms.2021.05.004"},{"key":"90207","doi-asserted-by":"crossref","unstructured":"Pluijmers BI, Ponniah AJ, Ruff C, et al. Using principal component analysis to describe the Apert skull deformity and simulate its correction. J Plast Reconstr Aesthet Surg. 2012;65(12):1750\u20131752. https:\/\/doi.org\/10.1016\/j.bjps.2012.07.007","DOI":"10.1016\/j.bjps.2012.07.007"},{"key":"90208","doi-asserted-by":"crossref","unstructured":"Srivilasa C, Zhao L, Patel PK, et al. Statistical shape analysis of metopic craniosynostosis: a preliminary study. Conf Proc IEEE Eng Med Biol Soc. 2006;2006:4066\u20134069. https:\/\/doi.org\/10.1109\/IEMBS.2006.260032","DOI":"10.1109\/IEMBS.2006.260032"},{"key":"90209","doi-asserted-by":"crossref","unstructured":"Staal FC, Ponniah AJ, Angullia F, et al. Describing Crouzon and Pfeiffer syndrome based on principal component analysis. J Craniomaxillofac Surg. 2015;43(4):528\u2013536. https:\/\/doi.org\/10.1016\/j.jcms.2015.02.005","DOI":"10.1016\/j.jcms.2015.02.005"},{"key":"90210","doi-asserted-by":"crossref","unstructured":"Way BLM, Khonsari RH, Karunakaran T, et al. Correcting exorbitism by monobloc frontofacial advancement in Crouzon-Pfeiffer syndrome: an age-specific, time-related, controlled study. Plast Reconstr Surg. 2019;143(1):121e\u2013132e. https:\/\/doi.org\/10.1097\/PRS.0000000000005105","DOI":"10.1097\/PRS.0000000000005105"},{"key":"90211","unstructured":"Nysj\u00f6 J. Interactive 3D image analysis for cranio-maxillofacial surgery planning and orthopedic applications. Acta Universitatis Upsaliensis; 2016."},{"key":"90212","doi-asserted-by":"crossref","unstructured":"Yushkevich PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage. 2006;31(3):1116\u20131128.https:\/\/doi.org\/10.1016\/j.neuroimage.2006.01.015","DOI":"10.1016\/j.neuroimage.2006.01.015"},{"key":"90213","doi-asserted-by":"crossref","unstructured":"Hoppe IC, Taylor JA. A cohort study of strabismus rates following correction of the unicoronal craniosynostosis deformity: conventional bilateral fronto-orbital advancement versus fronto-orbital distraction osteogenesis. J Craniofac Surg. 2021;32(7):2362\u20132365. https:\/\/doi.org\/10.1097\/SCS.0000000000007773","DOI":"10.1097\/SCS.0000000000007773"},{"key":"90214","doi-asserted-by":"crossref","unstructured":"Mayer DL, Hansen RM, Moore BD, et al. Cycloplegic refractions in healthy children aged 1 through 48 months. Arch Ophthalmol. Uppsala. 2001;119(11):1625\u20131628. https:\/\/doi.org\/10.1001\/archopht.119.11.1625","DOI":"10.1001\/archopht.119.11.1625"},{"key":"90215","doi-asserted-by":"crossref","unstructured":"Macintosh C, Wall S, Leach C. Strabismus in unicoronal synostosis: ipsilateral or contralateral? J Craniofac Surg. 2007;18(3):465\u2013469. https:\/\/doi.org\/10.1097\/scs.0b01e3180515d94","DOI":"10.1097\/scs.0b01e3180515d94"},{"key":"90216","doi-asserted-by":"crossref","unstructured":"Song HB, Yang HK, Baek RM, et al. Effect of fronto-orbital advancement on astigmatism in patients with anterior plagiocephaly. J Craniomaxillofac Surg. 2016;44(10):1504\u20131507. https:\/\/doi.org\/10.1016\/j.jcms.2016.04.028","DOI":"10.1016\/j.jcms.2016.04.028"},{"key":"90217","doi-asserted-by":"crossref","unstructured":"Tarczy-Hornoch K, Smith B, Urata M. Amblyogenic anisometropia in the contralateral eye in unicoronal craniosynostosis. J AAPOS. 2008;12(5):471\u2013476. https:\/\/doi.org\/10.1016\/j.jaapos.2008.03.008","DOI":"10.1016\/j.jaapos.2008.03.008"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/42322\/48455","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/42322\/48455","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T08:27:37Z","timestamp":1733992057000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/42322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":28,"URL":"https:\/\/doi.org\/10.2340\/jphs.v59.42322","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]}}}